Pregnancy Options: Abortion

Pregnancy Options: Abortion

As I wrote in my last post, when I was 15 my girlfriend and I discovered that she was pregnant. As you might surmise, this was an unintended pregnancy. Since it was unplanned we needed to consider our options and decide what to do about the pregnancy. If you read that post, you know that we decided against parenting and abortion and chose adoption as our course of action. In our case abortion was the first option that we discarded.

I did promise more to my story and I will get to that in another post. First I thought I would lay out the options that people facing an unplanned pregnancy have to choose from. I am going to cover them in the order that we considered them. So first up is abortion.

Abortion Decision

In our case the consideration of abortion of an option was quite brief. When we were on the bus home from the clinic where she had the pregnancy test done I asked J if she wanted to get an abortion. She said no. That was the end of it as far as we were concerned. According to notes from the social worker involved in our case there was some parental interest in abortion, but it was J’s choice and she didn’t want to have one.

Pregnancy Options in Canada

For many women and couples the decision is not that easy. For many it is. I asked Planned Parenthood Ottawa for information about abortion, adoption and parenting. Among many other services they offer a counselling service for women and partners facing unintended pregnancies and provide whatever information is requested.

I live in Canada and it is important to note that Canada has no abortion law whatsoever. This has been the case since 1988. Abortion is now considered a private medical matter between a person and their doctor. In most provinces abortion services are insured services funded by provincial health insurance plans. Abortion services are offered in some hospitals and in some private clinics. Access to services vary across the country. Generally speaking access is easier in urban areas as compared to rural areas. Third trimester abortions are not available in Canada.

Abortion Facts

There are of course people who would like abortion to be illegal in Canada. I am not writing this post to debate. I am writing this post to inform those facing unintended pregnancies like we did. For the record I am pro-choice – not pro-abortion. I do not encourage women to have abortions and clearly did not choose it in my own experience. I respect women’s right to choose the option that is best for them. It is not for me to judge or decide what is best of other people and I think that if someone disagrees with abortion, then they can choose not to have one, like we did. I expect there may be people who are opposed to women having abortion as a choice that may comment on this post. I am not going to engage in a debate the rightness or wrongness of abortion. That said, here is the information about abortion choices in Canada. Two options are available; surgical or medical (with medication) abortion.

Surgical Abortion: Procedure

Abortion procedures (e.g., in–take, counselling, anaesthetic, insurance coverage) will be different in every clinic/hospital.However, the basic abortion procedures are the same.

The procedures usually consist of:

Medical intake

Counselling

Ibuprofen to relax cervix

Ultrasound (the client may choose not to see the ultrasound)

Internal pelvic exam

Local anesthetic to numb the cervix or general anesthetic is used to “put you under”

Rods or laminaria (seaweed) to open cervix

Dilation

First Trimester Abortion:

Up to 12 weeks

Small tube removes the lining of the uterus (vacuum aspiration)

Lightly scoops products of conception from walls of uterus (curettage)

Recovery

Second Trimester Abortion:

Most often done in the hospital in Ottawa

Up to 19 weeks + 2 days in Ottawa (up to 22 weeks in Toronto)

Day 1: insert laminaria rod to gradually open cervix

Day 2: suction, forceps and curette

Dilation

Recovery

Abortion Recovery

During and after the procedure the client may feel menstrual type cramps for up to an hour along with vaginal bleeding.The client’s heart rate and blood pressure will be monitored and the amount of bleeding and discomfort will be checked to make sure it is within a normal range.Clients will be given antibiotics and be asked to come in for a follow-up appointment in two weeks at the clinic or with their family doctor.

Abortion Complications

Abortion is a very safe medical procedure when performed by a competent physician.Rare complications occur at a rate of 1 in 200,000.Complications can depend on age, pregnancy, skill of the doctor, anaesthesia, person’s health and the method of abortion.Complication rates are lower for first trimester and clients should be encouraged to see a doctor immediately if they feel there are any complications with the procedure.Some of the symptoms of complications are:

A fever higher than 38 C or 101 F

Severe and persistent cramping that cannot be relieved with Tylenol (some cramping is normal)

Very heavy bleeding, using one or more menstrual pads per hour for six hours

Complications are generally easy to treat if addressed immediately. The most common complications are infection, haemorrhage, allergic reaction to the medication or incomplete abortion.If a complication goes untreated, it could, potentially cause infertility. This was more common when abortion was illegal. Today, the possibility is nearly non-existent.

Medical Abortion: Procedure

What Is Medical Abortion?

A medical abortion is a termination of pregnancy, which is caused by a medication rather than by a surgical suction procedure. The medication can be administered via injection, be consumed orally in the form of a drink or inserted vaginally in tablet form.Methotrexate in combination with Misoprostol have been found to be over 95% successful in causing an abortion.

Who Is Suitable To Have A Medical Abortion?

To have this type of abortion, people must be very early in their pregnancy (up to 8 weeks in Ottawa).They must be comfortable with their decision to terminate the pregnancy, in good general health, and be able to tolerate possible heavy bleeding, cramping, and seeing the products of conception.Patients must avoid sex until the abortion is complete.

Advantages of Medical Abortion:

Can usually be performed without delay

Avoid anesthesia and surgical risks

Psychological advantage – patient control

Few contraindications to the medications used

Disadvantages of Medical Abortion:

There is a 3-5% chance that the treatment will not be effective or complete, and that a surgical abortion will be needed.

The abortion will take at least 1 week and may (very rarely) take as long as 5 weeks to complete.

Vaginal bleeding may be prolonged and heavy, rarely (less than 1%) requiring a surgical procedure (D&C) to completely empty the uterus.

Medication side effects (less than 10%) such as headaches, nausea, vomiting, sore mouth, dizziness or rash may occur.

The need for several clinic visits, blood tests and possibly ultrasounds.

Pregnancy Options Counselling

If you are dealing with an unintended pregnancy and you need information on the options available to you where you live, I would encourage you to find an organization or informed counselor who can talk to you about local resources available to you. We didn’t have access to a resource like Planned Parenthood Ottawa where I grew up and that is one of the reasons I am such a strong supporter of PPO and everything they do.